Información del artículo
Abstract
Objective
To determine the factors associated with the onset of cannabis use through a systematic review of cohort studies.
MethodsAn internet-based search was performed using several keywords and their combinations. Original studies with longitudinal design and the onset of cannabis use as dependent variable, as well as review studies were included, published between January 1980 and May 2004. Methodology quality of the studies was assessed independently by two reviewers, according to pre-established criteria, in order to classify studies in high, mid or low quality. Agreement between reviewers was assessed through kappa coefficient.
ResultsA total of 32 relevant studies were identified, of which 13 were of higher quality. Selection bias for the inclusion of consumers at the baseline measurement and lack or insufficient adjustment for confounders were the causes of exclusion. The factors of great evidence related to the onset of cannabis use were masculine sex, consumption of tobacco or alcohol, having a problematic relationship with parents, and cannabis consumption by friends.
ConclusionResults highlight the importance of different individual, family and environmental factors on the onset of cannabis use. These must be considered to properly arrange intervention programs focusing on primary prevention among teenagers.
Keywords:
Cannabis
Systematic review
Longitudinal studies
Resumen
Objetivo
Determinar los factores asociados al inicio del consumo de cannabis a partir de una revisión sistemática de estudios de cohortes.
MétodosSe realizó una búsqueda bibliográfica informatizada utilizando diversas palabras clave y sus combinaciones. Entre los estudios identificados se seleccionaron los estudios originales de diseño longitudinal que utilizaran como variable dependiente el inicio de consumo de cannabis, así como los estudios de revisión, publicados entre enero de 1980 y mayo de 2004. Se evaluó la calidad metodológica de los estudios mediante 2 revisores, de manera independiente y a partir de unos criterios prestablecidos, clasificando los artículos en 3 categorías: alta, intermedia o baja calidad. Se midió el nivel de concordancia de los revisores a partir del coeficiente kappa.
ResultadosSe identificaron 32 estudios que cumplían los criterios de selección, de los cuales 13 fueron determinados de alta calidad. Las causas de exclusión fueron el sesgo de selección, por la inclusión de consumidores al inicio de la cohorte estudiada, y la falta de ajuste por los potenciales confusores. Los factores que se relacionaron con una mayor evidencia con el inicio del consumo de cannabis fueron el sexo masculino, el consumo de tabaco y alcohol, tener una relación problemática con los padres y el consumo de cannabis por parte de los amigos.
ConclusionesLos resultados señalan la importancia de diversos factores individuales, familiares y del entorno en el inicio del consumo de cannabis, que deberían considerarse de forma conjunta en el abordaje preventivo entre los adolescentes.
Palabras clave:
Cannabis
Revisión sistemática
Estudios longitudinales
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